Revision Anterior Cruciate Ligament Reconstruction in an Adult Twin With Meier-Gorlin Syndrome

<h3>Background</h3> Meier-Gorlin syndrome is a rare autosomal recessive disorder characterized by the clinical triad of microtia, patellar aplasia or hypoplasia, and proportionate short stature. The absence of the patella poses 2 surgical challenges: lack of a donor site for graft harvest and lack of anterior restraint during anterior cruciate ligament (ACL) reconstruction surgery. Given that individuals with Meier-Gorlin syndrome generally exhibit normal cognitive function and life expectancy, ensuring knee stability is essential to support their ability to participate in sports and engage in daily activities independently. <h3>Case Report</h3> We present the case of an adult twin with Meier-Gorlin syndrome who had an absent patella and recurrent knee instability after ACL retear. At 2-year follow-up after revision ACL reconstruction, the patient9s Single Assessment Numeric Evaluation score had increased to 100 from a preoperative score of 30. The patient reported excellent pain relief and was able to perform all activities of daily living. <h3>Conclusion</h3> Successful revision ACL reconstruction is possible in a patient with Meier-Gorlin syndrome. However, these patients may be at higher risk of revision because of the lack of the anterior constraint provided by a normal extensor mechanism with a present patella.